Behavioral Patterns Toward Preventive Dental Care at School Dental Camps: An Observational Study in Bengaluru.

Background Dental behavior management problems of children towards preventive dental care at school dental camps in India remain largely undocumented. This study aimed to assess such behavior patterns in preschool and school-age children at a school dental health camp. Materials and methods The cross-sectional study included 462 children, with 261 children each in the preschool (three to five years old) and school (six to 12 years old) age groups in Bengaluru. On the school dental camp day, their behavior and anxiety were gauged using the Frankl Behavior Rating Scale and the Raghavendra, Madhuri, and Sujata Pictorial Scale, respectively. The Chi-square test was used to uncover predictive variables for children's behavior patterns toward preventive dental procedures at the dental school camps. Results A high prevalence of definitely negative Frankl Behavior Rating Scale ratings (59%, n=272) and dental anxiety (53%, n=245) were noted among the participants. Age, sex, the area of residence of the child, and the previous history of dental visits and treatment were predictors of their behavior at a school dental camp setup. Conclusion The present study gives an insight into the behavior of children towards preventive dental care at a school dental camp in a mobile dental van, stressing the need for behavior assessment before the treatment.

Evaluation of Osteogenic Potential of Fucoidan Containing Chitosan Hydrogel in the Treatment of Periodontal Intra-Bony Defects-A Randomized Clinical Trial.

Periodontal diseases significantly impact about half of the global population, and their treatment often encompasses relieving symptoms as well as regenerating the destroyed tissues. Revolutionary research in the management of periodontal disease includes biomaterials, a boon to re-generative dentistry owing to their excellent biological properties: non-toxicity, anti-inflammatory, biocompatibility, biodegradability, and adhesion. This study aimed to fabricate an injectable fucoidan containing chitosan hydrogel and prove its effectiveness in periodontal bone regeneration. The injectable hydrogel was prepared using the sol-gel method and was subjected to various physical, chemical, and biological characterizations to understand its efficacy in formation of new bone. The effectiveness of the developed hydrogel was assessed in periodontal bony defects to study the soft and hard tissue changes. A total of 40 periodontitis patients with bony defects were recruited and randomized into two groups to receive fucoidan-chitosan hydrogel and concentrated growth factor, respectively. Customized acrylic stents were used to guide the hydrogel placement into the defect site. Post-surgical changes in clinical parameters were assessed at 3, 6, and 9 months to appreciate the soft and hard tissue changes using repeated measures analysis of variance and Bonferroni's post hoc test. Significance was kept at 5%. The porosity, water uptake of the prepared hydrogel showed good efficacy, with particle size of the fucoidan containing chitosan hydrogel of 6.000 nm. The MG-63 osteoblasts cell line revealed biocompatibility, biodegradability and showed slow and sustained drug release, increased cell proliferation, and enhanced alkaline phosphatase secretion. Mineralization assay was greatest in the fucoidan containing chitosan hydrogel. Clinically, it exhibited significantly lower probing depth values and a higher mean improvement in clinical attachment level as compared to the concentrated growth factor (CGF) group at the end of 3 and 6 months (p < 0.05). The mean of the defect fills in the fucoidan containing chitosan group was 1.20 at the end of 9 months (p < 0.001) as compared with defect fills observed in the CGF group. The presence of fucoidan in the hydrogel significantly contributed to bone regeneration in humans, thus strengthening its potential in tissue engineering. Fucoidan-chitosan will be a promising biomaterial for bone tissue regeneration.

Piperine-Loaded In Situ Gel: Formulation, In Vitro Characterization, and Clinical Evaluation against Periodontitis.

Periodontitis is an inflammatory disorder associated with dysbiosis and characterized by microbiologically related, host-mediated inflammation that leads to the damage of periodontal tissues including gingiva, connective tissues, and alveolar bone. The aim of this study was to develop an in situ gel consisting of piperine. Eight in situ gel formulations were designed by varying the concentration of deacylated gellan gum cross-linked with sodium tripolyphosphate, and poloxamer-407. The prepared gels were evaluated for gelation temperature, gelation time, viscosity, piperine-loading efficiency, and piperine release. Finally, the optimized formula was evaluated for anti-inflammatory effectiveness among human patients during a 14-day follow-up. The optimized in situ gel formulation exhibited a gelation temperature of 35 ± 1 °C, gelling of 36 ± 1 s, excellent syringeability, and piperine loading of 95.3 ± 2.3%. This formulation efficiently sustained in vitro drug release for up to 72 h. In vivo studies revealed an efficient sol-to-gel transformation of optimized in situ gel formulation at physiological conditions, permitting an efficient residence time of the formulation within a periodontitis pocket. Most importantly, a clinical study revealed that treatment with the optimized formulation elicited a significant reduction in the mean plaque score (p = 0.001), gingival index (p = 0.003), and pocket depth (p = 0.002), and exerted a potent anti-inflammatory potential, compared to the control group. Collectively, piperine-loaded in situ gel might represent a viable therapeutic approach for the management of gingival and periodontal diseases.

Emergency Preparedness and Modish Practices among Primary Healthcare Delivery Systems Facilitated through Public-private Partnership Models in a South Indian Metropolitan City: A Descriptive Cross-sectional Study.

Background and aim: Access to health care is supposed to be a basic human right but the present scenario of the healthcare sector in India displays a large disparity in the healthcare services provided by the public and private sectors with wide variations in the infrastructure and services delivered by both sectors. Hence, public-private partnership (PPP) in healthcare delivery is an urgent and essential component that needs attention to ameliorate this gap. The aim of this study was to assess the current practices in healthcare services provided through PPPs in Bengaluru city. Materials and methods: A cross-sectional questionnaire survey was conducted among primary healthcare centers (PHC) run under PPP in Bengaluru city, Karnataka, India. The pretested self-designed structured questionnaire consisted of 18 items regarding the current practices of PPP at the primary healthcare level. Descriptive statistics were used to describe the data. Results: A total of 15 PPPs at the primary healthcare level were identified and included in the study. All of the participants provided basic healthcare services, some participants (33%) provided specialized services, and some (27%) mobile healthcare services. The overall impression of the medical officers in charge interviewed was that PPPs are better than individual endeavors by both public and private sectors. They also believed that it was important to have policies and guidelines in place to monitors aspects like the functioning of the setup, risk sharing, etc. Conclusion: The results indicated that all the participants were at the primary healthcare level and mostly involved in preventive practices. It is also important to look at venturing into services that provide curative services as well. Oral health, however, did not prominently feature at any point and is another area that requires attention. How to cite this article: Mukherji I, Eshwar S, Srivastava BK, et al. Emergency Preparedness and Modish Practices among Primary Healthcare Delivery Systems Facilitated through Public-private Partnership Models in a South Indian Metropolitan City: A Descriptive Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(2):153-158.

"BRUSH UP": AN INNOVATIVE TECHNOLOGICAL AID FOR PARENTS TO KEEP A CHECK OF THEIR CHILDREN'S ORAL HYGIENE BEHAVIOUR.

OBJECTIVE: To investigate the impact of "Brush Up" - a mobile application, on oral hygiene behaviours of 4-6-year-old children in Bangalore city. METHODS: In this experimental study, 247 children aged 4-6, were randomly divided into three groups. Considering "Brush Up" is a mobile application, parents of the children in Group 1 (n=82) downloaded the application on their smartphones. Children in Group 2 (n=83) and Group 3 (n=82) received tooth brushing instructions by an educative video and manual demonstration, respectively. Effectiveness of tooth brushing was assessed with plaque scores, which were recorded for all the groups at baseline and one month using Visible Biofilm Index. RESULTS: Wilcoxon signed rank test showed a significant improvement in the tooth brushing behaviour for the Brush Up group, which was indicated by a lower plaque score after a follow-up of one month. Kruskal-Wallis test followed by post-hoc test showed that the mean ranks of plaque scores of Brush Up group are consistently lower than those of video demonstration group and manual demonstration group. CONCLUSIONS: The lower plaque score in subsequent follow-up in Brush Up group suggests that using a smart system can enhance learning a correct tooth brushing method in young children and can also help in implementing the required reinforcement and motivation to brush and aid in better plaque control.

Brush up: an innovative technological aid for parents to keep a check of their childrens oral hygiene behaviour / Brush up: uma ajuda tecnológica inovadora para os pais controlarem o comportamento de higiene bucal de seus filhos

ABSTRACT Objective: To investigate the impact of "Brush Up" - a mobile application, on oral hygiene behaviours of 4-6-year-old children in Bangalore city. Methods: In this experimental study, 247 children aged 4-6, were randomly divided into three groups. Considering "Brush Up" is a mobile application, parents of the children in Group 1 (n=82) downloaded the application on their smartphones. Children in Group 2 (n=83) and Group 3 (n=82) received tooth brushing instructions by an educative video and manual demonstration, respectively. Effectiveness of tooth brushing was assessed with plaque scores, which were recorded for all the groups at baseline and one month using Visible Biofilm Index. Results: Wilcoxon signed rank test showed a significant improvement in the tooth brushing behaviour for the Brush Up group, which was indicated by a lower plaque score after a follow-up of one month. Kruskal-Wallis test followed by post-hoc test showed that the mean ranks of plaque scores of Brush Up group are consistently lower than those of video demonstration group and manual demonstration group. Conclusions: The lower plaque score in subsequent follow-up in Brush Up group suggests that using a smart system can enhance learning a correct tooth brushing method in young children and can also help in implementing the required reinforcement and motivation to brush and aid in better plaque control.

RESUMO Objetivo: Investigar o impacto do "Brush Up", um aplicativo móvel, sobre comportamentos de higiene bucal de crianças de 4 a 6 anos na cidade de Bangalore, na Índia. Métodos: Neste estudo experimental, 247 crianças de 4 a 6 anos foram divididas aleatoriamente em 3 grupos. Como "Brush Up" é um aplicativo móvel, os pais das crianças do Grupo 1 (n=82) baixaram o aplicativo em seus smartphones. As crianças do grupo 2 (n=83) e do grupo 3 (n=82) receberam instruções sobre escovação por meio de vídeo educativo e demonstração manual, respectivamente. A efetividade da escovação foi avaliada por meio de escores de placa bacteriana, registrados para todos os grupos antes da intervenção e um mês depois. Resultados: O teste de Wilcoxon sinalizou uma melhora significativa na escovação para o grupo "Brush Up", com uma pontuação mais baixa na placa bacteriana após um mês de acompanhamento. O teste de Kruskal-Wallis, seguido do teste post hoc, mostrou que as classificações médias das pontuações do grupo "Brush Up" foram consistentemente mais baixas do que as do grupo com demonstração em vídeo e demonstração manual. Conclusões: Os resultados obtidos no grupo "Brush Up" sugerem que o uso de um sistema inteligente pode melhorar o aprendizado de um método correto de escovação em crianças pequenas e ajudar na implementação do reforço e motivação necessários para escovar e controlar melhor a placa bacteriana.

Clinical outcomes of ultrashort sloping shoulder implant design: A survival analysis.

BACKGROUND: Short implants are preferred in cases of limited bone height. Length and design of implant credits to stability and implant success, shorter implants tend to survive for longer time duration. PURPOSE: Retrospective cohort study was conducted with an aim to assess the clinical outcome and cumulative survival rate of sloping shoulder implants over a period of 8 years. MATERIALS AND METHODS: Data was collected from all patients attending private clinics in Dubai, UAE. Subjects received ultrashort sloping shoulder (Bicon) implant. Implants of 6 mm and less than 6 mm length were included in the study. Subject's information like age, gender, systemic condition, habits, and radiographs were collected. Implant variables that is number of implants placed, location of placement, loading type, bone type, bone condition, and graft type were collected. Data was analyzed using multivariate cox regression model to evaluate the correlation between implant variables and to identify the implant variables associated with failure. Kaplan-Meier method was adopted to assess the survival pattern of implants. RESULTS: Cumulative survival rate was 97% with average follow up of 28 months. Statistically significant differences were seen with implant length, arch type, bone type, and bone condition with P value <.001. CONCLUSION: Short implants with sloping shoulder design and plateau-type roots have superior survival rates when compared with regular implants. The bone condition was also witnessed to be statistically significantly superior.

New Vision for Improving the Oral Health Education of Visually Impaired Children- A Non Randomized Control Trial.

INTRODUCTION: Visually impaired people have poorer oral hygiene when compared to others. Therefore, there is a necessity for individual training by making awareness in oral care and plaque control so as to improve their oral hygiene. AIM: The aim of the present study was to assess the effectiveness of oral health innovative educative method among visually impaired children of Bengaluru city of India. MATERIALS AND METHODS: A non-randomized control trial was conducted among 40 visually impaired individuals attending special school for blind. The study was conducted for a duration of six months. Baseline data regarding oral health knowledge, attitude and practices was obtained through a questionnaire in Braille and oral plaque assessment was done using Silness and Loe plaque index (1964). Music based brushing technique, cast models and an oral health education talk and booklet in Braille was delivered stressing on importance of oral health. The results of Knowledge, Attitude and Practices (KAP) before and after health education were analysed using Chi-square test with SPSS version 22.0. RESULTS: The overall KAP was lower in the preintervention period among the visually impaired children with mean score of 6.98 while after the modified oral health education session, it was increased to a mean score of 14.68 which was statistically significant at p<0.001. There was a significant change in the oral plaque scores with 80% of the children having fair scores in the preintervention period to 30% in the postintervention period. CONCLUSION: This oral health education module showed good results which can be implemented to effectively increase the awareness about dental health.

Comparison of Platform Switched and Sloping Shoulder Implants on Stress Reduction in various Bone Densities: Finite Element Analysis.

INTRODUCTION: Comparison of platform switched (PS), sloping shoulder, and regular implants on stress reduction in various bone densities with finite element analysis. MATERIALS AND METHODS: A total of 12 three-dimensional finite element models were built to analyze the stress distribution model. Nobel Biocare 4.3 × 8 mm regular platform replace select implant with matching diameter easy abutment, Nobel Biocare 4.3 × 8 mm replace select implant PS with 3.5 mm diameter easy abutment, Bicon 4 × 8 mm implant with 4 mm diameter sloping shoulder abutments were created virtually in compact bone density using software. The 130 N axial force and a 90 N oblique loading force were applied to the abutment to analyze the stress. RESULTS: Under horizontal and vertical loading, the sloping shoulder implant had lesser stresses in cancellous bone when compared with PS and regular implants. Sloping shoulder implant showed more stress distribution at implant-abutment interface and at crestal area, whereas with regular implants, the stresses were distributed at cortical area. CONCLUSION: Sloping shoulder implant in subcrestal position is much favorable for bone growth, stress distribution, and preservation of remaining bone. CLINICAL SIGNIFICANCE: Use of sloping shoulder implant design distributes the stress apically and creates lesser stresses when compared with PS implants.

Comparative Evaluation of Antibacterial and Adhesive Properties of Chitosan Modified Glass Ionomer Cement and Conventional Glass Ionomer Cement: an In vitro Study.

INTRODUCTION: Recent studies have reported the incorporation of modifiers with conventional Glass Ionomer Cement (GIC) to enhance its antibacterial effect. One such modification being the addition of Chitosan (CH). However, these modifiers might affect the physical properties of the restorations. AIM: The aim of the present study was to investigate the effect of modifying the liquid phase of conventional GIC with 10% v/v CH on the antibacterial properties and adhesion to enamel in comparison to conventional GIC. MATERIALS AND METHODS: The liquid of commercially available restorative GIC (Fuji IX, GC Industrial Corporation, Japan) was modified with 10% v/v CH solution (Everest Biotech, Bengaluru). GIC powders were mixed with the unmodified and the CH-modified liquids at the desired powder/liquid ratio. Fourier Transform Infrared Spectroscopy (FTIR) was used to determine the setting reaction between the conventional and CH modified GIC liquid with GIC powder. For evaluation of the antibacterial properties, biofilms of Streptococcus mutans (S. mutans) were formed on the GIC discs and characterized by Scanning Electron Microscope (SEM). For the characterization of the adhesive properties, the unmodified and CH-modified GICs were bonded to the enamel surface and the microshear bond strength (µSBs) was evaluated. Student's paired t-test was used to compare the micro-shear bond strength between CH modified GIC and unmodified GIC. RESULTS: Modification with 10% v/v CH solution improved the antibacterial properties of GIC against S. mutans in terms of resistance to biofilm formation which was assessed using SEM. Microshear bond strength of CH modified GIC was 85.40 MPa compared to 46.94 MPa of conventional GIC. This difference was found to be statistically significant. CONCLUSION: Modifying the liquid phase of a conventional GIC with 10% v/v CH significantly improves the antibacterial property of GIC as well as its adhesion to enamel.

Comparison of Dill Seed Oil Mouth Rinse and Chlorhexidine Mouth Rinse on Plaque Levels and Gingivitis - A Double Blind Randomized Clinical Trial.

INTRODUCTION: Mouthrinses have been in use for centuries as breath fresheners, medicaments, and antiseptics. Dill is said to be a good source of calcium, manganese and iron. It contains flavonoids known for their antioxidant, anti-inflammatory, and antiviral properties. Dill can help with microbial infections in the mouth; and its anti-oxidants minimize damage caused by free radicals to the gums and teeth. Being a good source of calcium, dill also helps with bone and dental health. AIMS AND OBJECTIVES: To compare the effectiveness of commercially available 0.2% chlorhexidine gluconate mouthrinse and dill seed oil mouthrinse on plaque levels and gingivitis. MATERIAL AND METHODS: A randomized controlled, double blind parallel arm study was conducted over 90 days on 90 subjects. The subjects were randomly divided into 2 groups and baseline data was collected using Loe and Silness gingival index and Quigley Hein plaque index and oral prophylaxis was performed on all the subjects. The mouthrinses included in the present study were dill seed oil and Hexodent (0.2% chlorhexidine gluconate). Intervention regarding the mouthrinsing was given to the subjects and were followed up for 45 days and 90 days, after this post intervention changes were assessed using the respective indices. RESULTS: It was observed that there is no significant difference in gingival & plaque scores among two mouthrinses from baseline to 45 days and 90 days. It was observed that there is statistical difference in gingival and plaque scores when compared with baseline to 45 days (p<0.001), baseline to 90 days (p<0.001) and 45 days to 90 days (p<0.001) when intergroup comparisons were done. CONCLUSION: It was concluded that dill seed oil and Hexodent (0.2% chlorhexidine gluconate) mouthrinse have similar antiplaque and antigingival effectiveness.

Cognitive Ability as a Determinant of Socioeconomic and Oral Health Status among Adolescent College Students of Bengaluru, India.

INTRODUCTION: Levels of oral health and economic status are unequally distributed throughout the population. Inequality has multiple causes and that the effect of Socio Economic Status (SES) and demographic factors, on oral health is mediated through several factors. Association between cognitive ability and oral health had been demonstrated in older age groups but adolescents and younger adults have received relatively little attention in this field. AIM: To establish the role of cognitive ability as a determinant of SES and oral health status among adolescent college students of Benagluru, Karnataka, India. MATERIALS AND METHODS: A cross-sectional study was conducted among 1000 adolescents aged 17-19 years. Six government and six private first grade colleges were selected by multi-stage random sampling. Cognitive ability was assessed using digit symbol substitution test and digit span test. Dental caries and periodontal status were recorded by extent of bleeding, presence of calculus, periodontal pockets, loss of attachments using Community Periodontal Index, decayed, missing and filled teeth surfaces using Decayed, Missing, Filled Teeth and Surfaces Index. SES status was assessed using Kuppuswamy scale. Chi-square test was used to check the association of cognitive ability with oral health indicators and SES status. Regression analysis was performed to assess the effect of cognitive ability on oral health indicators after adjusting for SES and effect of SES status on oral health indicators after adjusting for indicators of cognitive ability. RESULTS: Significant association and negative correlation between cognitive ability and indicators for oral health was seen in the regression models. Cognitive ability attributed for nearly 30% changes in the indicators for oral health after adjusting for SES and SES attributed for nearly 25% variance in indicators for oral health after adjusting for cognitive ability. CONCLUSION: There is a potential role of cognitive ability in SES and oral health.

Evaluation of periodontal risk assessment model among adults aged 30-60 years attending KLE Dental College, Belgaum: A hospital-based study.

AIM: The aim of the present study was to evaluate the periodontal risk of individuals using the modified periodontal risk assessment model. MATERIALS AND METHODS: Adult subjects aged 30-60 years attending the out patient department of Institute of Dental Sciences, Belgaum in a week's period were screened and 30 among those who met the criteria were included in the study. Complete history and examination of the oral cavity was done using mouth mirror and community periodontal index probes. Periodontal status was recorded using community periodontal index. Systemic conditions like hypertension and diabetes was assessed by suitable investigations. All the risk factors were plotted on a model using Microsoft excel and periodontal risk was assessed based on the findings and categorized as low, moderate and high risk. RESULTS: Among 30 patients 13 were in low risk group, 10 in moderate risk group, and 7 in high risk group identified by proposed model given by Vishwa Chandra whereas 20 patients were in low risk group, 5 in moderate risk group and 5 in high risk group when identified Lang and Tonetti model (2003). CONCLUSION: In conclusion the use of risk assessment tool would result in reduction of complex therapies and would prevent the future effects of periodontal disease such as bone and tooth loss.